Association of Body Mass Index of HIV-1-Infected Pregnant Women and Infant Weight, Body Mass Index, Length, and Head Circumference: The NISDI Perinatal Study.

This study assessed the relationship between the body mass index (BMI) of HIV-1-infected women and their infants' perinatal outcomes. The study population consisted of women enrolled in the NICHD International Site Development Initiative (NISDI) Perinatal Study with data allowing calculation of the BMI adjusted for length of gestation (adjBMI), who delivered singleton infants. Outcome variables included infant growth parameters at birth (weight, BMI, length and head circumference) and gestational age. Of 697 women from Argentina, the Bahamas, Brazil and Mexico who were included in the analysis, the adjBMI was classified as underweight for 109 (15.6%), normal for 418 (60.0%), overweight for 88 (12.6%) and obese for 82 (11.8%). Median infant birth weight, BMI, birth length and head circumference differed significantly according to maternal adjBMI (P</=0.0002). Underweight mothers gave birth to infants with lower weight, lower BMI, shorter length and smaller head circumference, while infants born to normal, overweight and obese mothers were of similar size

Global trends and current status in pheochromocytoma: a bibliometric analysis of publications in the last 20 years

ObjectivePheochromocytoma is a rare catecholamine-producing neuroendocrine tumour originating from the chromaffin cells of the adrenal medulla or extra-adrenal paraganglia. However, there are few bibliometric studies on Pheochromocytoma. Therefore, this study was employed to summarize the global trends and current status in pheochromocytoma by bibliometric analysis.Materials and methodsThe Web of Science (WOS) core collection database was searched for publications relating to pheochromocytoma from 2001 to 2021. Bibliometric analysis was used to examine the data, and Microsoft Excel was utilized to create bar graphs. In addition, VOSviewer was used to carry out co-authorship analysis, co-citation analysis and co-occurrence analysis. CiteSpace was used to analyze the keywords citation bursts.ResultsA total of 8,653 publications published in 1,806 journals by 38,590 authors in 6,117 organizations from 100 countries/regions were included in our study. Among them, USA was the leading countries in terms of total publications and sum of time cited, whereas Eunice Kennedy Shriver Natl Inst Child Hlth &amp; Hum was the leading institutions. The main publications for pheochromocytoma-related articles were Journal of clinical endocrinology &amp;metabolism. Pacak karel and Eisenhofer Graeme were the main contributing authors. The studies on pheochromocytoma could be grouped into five clusters: Treatment, Mechanism, Etiology, Radiology and Hormones study. Moreover, the radiology study, etiology study and some specific keywords such germlines mutation, mesenchymal stem-cells, autophagy, neuroinflammation, neurotoxicity, and hemodynamic instability, may become the hot spots of future.ConclusionAlthough the number of articles on pheochromocytoma has fluctuated slightly over the past 20 years, there has been an overall upward trend. In general, precision medicine research on pheochromocytoma, especially metastatic pheochromocytoma, in terms of diagnosis, treatment, and etiology will be a hot research topic in the future. This study helps to understand the research perspectives, hot spots and trends of pheochromocytoma and provide new insight and a basis for future pheochromocytoma research quickly

Combined evaluation of sexually transmitted infections in HIV-infected pregnant women and infant HIV transmission

Background Sexually transmitted infections (STIs) including Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Treponema pallidum (TP), and cytomegalovirus (CMV) may lead to adverse pregnancy and infant outcomes. The role of combined maternal STIs in HIV mother-to-child transmission (MTCT) was evaluated in mother-infant pairs from NICHD HPTN 040. Methodology Urine samples from HIV-infected pregnant women during labor were tested by polymerase chain reaction (PCR) for CT, NG, and CMV. Infant HIV infection was determined by serial HIV DNA PCR testing. Maternal syphilis was tested by VDRL and confirmatory treponemal antibodies. Results A total of 899 mother-infant pairs were evaluated. Over 30% had at least one of the following infections (TP, CT, NG, and/or CMV) detected at the time of delivery. High rates of TP (8.7%), CT (17.8%), NG (4%), and CMV (6.3%) were observed. HIV MTCT was 9.1% (n = 82 infants). HIV MTCT was 12.5%, 10.3%, 11.1%, and 26.3% among infants born to women with CT, TP, NG or CMV respectively. Forty-two percent of HIV-infected infants were born to women with at least one of these 4 infections. Women with these infections were nearly twice as likely to have an HIV-infected infant (aOR 1.9, 95% CI 1.1-3.0), particularly those with 2 STIs (aOR 3.4, 95% CI 1.5-7.7). Individually, maternal CMV (aOR 4.4 1.5-13.0) and infant congenital CMV (OR 4.1, 95% CI 2.2-7.8) but not other STIs (TP, CT, or NG) were associated with an increased risk of HIV MTCT. Conclusion HIV-infected pregnant women identified during labor are at high risk for STIs. Co-infection with STIs including CMV nearly doubles HIV MTCT risk. CMV infection appears to confer the largest risk of HIV MTCT.NICHD (NICHD)(Brazilian AIDS Prevention Trials International Network), NIAID/ NIHNational Institute of Allergy and Infectious Diseases (NIAID)Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)National Institute of Mental Health (NIMH)Boehringer Ingelheim Pharmaceuticals Inc. (BIPI)GlaxoSmithKline, on behalf of ViiV HealthcareCepheid for the testing of CTNG in a prior HPTNUCLA Children's Discovery and Innovation Institute (CDI) through the Harry Winston Fellowship AwardUCLA AIDS InstituteUCLA Center for AIDS Research (CFAR) NIH/ NIAIDUCLA Pediatric AIDS Coalition, and WestatNIH/NICHDDavid Geffen UCLA Sch Med, Los Angeles, CA 90095 USAWestat Corp, Rockville, MD USAFundacao Oswaldo Cruz FIOCRUZ, Rio De Janeiro, RJ, BrazilUS Dept State, Off Global AIDS Coordinator, Washington, DC 20520 USAElizabeth Glaser Pediat AIDS Fdn, Washington, DC USAHosp Geral Nova Iguacu, Nova Iguacu, RJ, BrazilHosp Fed Servidores Estado, Rio De Janeiro, RJ, BrazilUniv Witwatersrand, SAMRC & Perinatal HIV Res Unit, Johannesburg, South AfricaStellenbosch Univ, Tygerberg Hosp, Cape Town, South AfricaHosp Conceicao, Porto Alegre, RS, BrazilHosp Femina, Porto Alegre, RS, BrazilIrmandade Santa Casa Misericordia Porto Alegre, Porto Alegre, RS, BrazilUniv Fed Minas Gerais, Belo Horizonte, MG, BrazilUniv Sao Paulo, Ribeirao Preto Med Sch, Sao Paulo, BrazilFdn Maternal & Infant Hlth FUNDASAMIN, Buenos Aires, DF, ArgentinaUniv Fed Sao Paulo, Escola Paulista Med, Sao Paulo, SP, BrazilEunice Kennedy Shriver Natl Inst Child Hlth & Hum, NIH, Bethesda, MD USAUCLA, Fielding Sch Publ Hlth, Los Angeles, CA USAUCSD Sch Med, La Jolla, CA USAUC Davis Sch Med, Davis, CA USABoston Univ, Sch Med, Boston, MA 02118 USAUniv Fed Sao Paulo, Escola Paulista Med, Sao Paulo, SP, BrazilNICHD (NICHD): HHSN267200800001C, N01-HD-8-0001Brazilian AIDS Prevention Trials International Network: NIAID/ NIH [U01 AI047986National Institute of Allergy and Infectious Diseases (NIAID): U01 AI068632, UM1AI068632, UM1AI068616, UM1AI106716NIMH: AI068632NG in a prior HPTN :040UCLA Center for AIDS Research (CFAR) NIH/ NIAID: AI02869, AI28697NIH/NICHD: HHSN275201300003CWeb of Scienc

Analysis of cervicovaginal fluid metabolome and microbiome in relation to preterm birth.

The biochemical activities and resultant metabolic by-products of the vaginal microbial community during gestation can provide useful insight into the pathophysiology of preterm birth (PTB), as well as help in identifying women at risk. These metabolic changes leave specific signature fingerprints that can be investigated by Magnetic resonance spectroscopy (MRS). Therefore, we hypothesised that women who ultimately deliver prematurely will have significantly different vaginal microbiota metabolite signatures compared to their term counterparts even in the absence of clinical infection. In order to characterise and validate the cervicovaginal fluid (CVF) metabolite profiles and determine their predictive capacities for PTB, high-vaginal swabs were obtained from asymptomatic and symptomatic pregnant women sub-classified depending on a previous history of PTB and/or short cervix (< 25 mm) into: asymptomatic low risk (ALR) women with no prior PTB nor short cervix, 20-22 gestational weeks (w), n = 183; and asymptomatic high risk (AHR) women with prior history of PTB and/or short cervix, 20-22 w, n = 186. A subset of these women were assessed again at 26-28 w (due to their high-risk status), n = 129. The fourth cohort comprised women presenting with symptoms of threatened preterm labour (PTL) 24-36 w, n = 89 (SYM). CVF dissolved in phosphate buffered saline was analysed with a 9.4T MR spectrometer. Metabolites were identified, integrated for peak area and normalised to the total spectrum integral (excluding water signal). Acetate concentrations (AceConc) were also determined from a randomly selected subset of SYM women (n = 57), by a spectrophotometric technique. Additionally, clinical parameters such as cervical length (CL), fetal fibronectin (FFN), and vaginal pH were recorded and correlated to the metabolites. Furthermore, the 16S rDNA of vaginal bacterial species were PCR-amplified and the vaginal cytology was also determined by Gram, Hematoxylin and eosin, and Papanicolaou staining methods. We observed that acetate normalised integral (N.I.) (P = 0.002), and acetate/lactate ratio (P = 0.002) were higher in the SYM women who delivered preterm. These were also predictive of PTB < 37 w (AUROC: acetate N.I. = 0.75; acetate/lactate ratio = 0.76), < 32 w (AUROC: acetate N.I. = 0.73; acetate/lactate ratio = 0.79), and within 2 weeks of the index assessment (AUROC: acetate N.I. = 0.77; acetate/lactate ratio = 0.78), whilst glutamine/glutamate N.I.s was predictive of PTB < 32 w (AUROC = 0.71), and within 2 weeks of the index assessment (AUROC = 0.68) only. Also, in the AHR20-22w and ALR women, acetate (AUROC = 0.61) and branched chain amino acids N.I.s (AUROC = 0.75) were predictive of PTB < 37 w respectively. Normalised integrals of succinate, formate, lactate, and glucose did not differ in relation to PTB in any of the groups. Like the acetate N.I.s, AceConc in the SYM women was higher (P = 0.006) in the preterm-delivered women and was predictive of PTB 0.53 g/l. AceConc also correlated with acetate N.I. (r = 0.69; P < 0.0001). PCR revealed a higher prevalence of potentially pathogenic anaerobic bacteria species in the preterm-delivered women across the groups except the ALR women. Apart from correlating with clinical parameters, the prediction of PTB was improved especially in the SYM women when metabolite N.I.s, CL and FFN were combined. In conclusion, elevated CVF acetate showed clinically useful discriminative propensity for preterm delivery and delivery within 2 weeks of presentation in symptomatic women. A ratio of acetate to lactate showed similar discriminatory capacity in symptomatic women, whilst branched chain amino acids appeared predictive of preterm delivery in asymptomatic women at low risk of PTB. These metabolite differences were supported with the association of higher prevalence of mixed anaerobes in the vaginal melieu and preterm birth

The influence of gestational age on social attention and language in the second year of life

Premature birth is common worldwide and does not show signs of decreasing. In rich countries, assisted reproductive techniques contribute to maintain the rate high. Infants born prematurely are more at risk for a series of complications that could affect their cognitive and emotional performances well into teenage years and adulthood. Research on premature delivery is complicated by a series of methodological difficulties and is still largely based on data collected decades ago, when medical procedures in the neonatal units were different. Moreover, the development of socio-cognitive abilities in infants born preterm, in particular concerning moderate to late prematurity, is still understudied. The Special Delivery study was set up to address these gaps in the literature,through a short-term longitudinal study. A multi-method approach provided tools to explore different cognitive and social abilities from birth up to 24 months of age. Infants born at extremely low gestational ages and with complicated medical situations were excluded, in order to better explore the influence of prematurity alone. This thesis focuses on social attention and language between 13 and 24 months. Infants born preterm showed a delay in language abilities at 18 and 24 months and gestational age correlated positively with both receptive and expressive vocabulary size at both ages. Also some social attention behaviours were affected by prematurity. In particular, responding to joint attention and initiating behavioural request had lower scores in the preterm born sample, while initiating joint attention had no relation with the participants' birth status. With regard to the relation between social attention and language, the effect of gestational age on receptive vocabulary at 24 months was completely mediated by responding to joint attention skills at 13 months. It was concluded that prematurity in a healthy sample affects mainly responding to joint attention, which in return has a negative impact on subsequent language development

Prevalence and Associated Characteristics of HIV-Infected Children in Latin America Who Know Their HIV Status

We estimated the prevalence of human immunodeficiency virus (HIV) disclosure in children from a prospective observational cohort study conducted at clinical sites in Brazil, Mexico, and Peru. Fewer than half of the children in this study knew their HIV status, which highlights the need for better strategies for disclosure that are age and culturally appropriate.Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentEunice Kennedy Shriver Natl Inst Child Hlth & Hum, NIH, Bethesda, MD USAUniv Nacl Mayor San Marcos, Inst Med Trop Daniel Carrion, Lima, PeruUniv Fed Sao Paulo, Escola Paulista Med, Sao Paulo, BrazilHosp Femina, Porto Alegre, RS, BrazilWestat Corp, Rockville, MD USAUniv Fed Sao Paulo, Escola Paulista Med, Sao Paulo, BrazilEKSNUCHHD: N01-HD-3-3345EKSNUCHHD: HHSN267200800001CEKSNUCHHD: HHSN275201300003CWeb of Scienc

Undervaccination of Perinatally HIV-infected and HIV-exposed Uninfected Children in Latin America and the Caribbean

Background: Perinatally HIV-infected (PHIV) children may be at risk of undervaccination. Vaccination coverage rates among PHIV and HIV-exposed uninfected (HEU) children in Latin America and the Caribbean were compared.Methods: All PHIV and HEU children born from 2002 to 2007 who were enrolled in a multisite observational study conducted in Latin America and the Caribbean were included in this analysis. Children were classified as up to date if they had received the recommended number of doses of each vaccine at the appropriate intervals by 12 and 24 months of age. Fisher's exact test was used to analyze the data. Covariates potentially associated with a child's HIV status were considered in multivariable logistic regression modeling.Results: of 1156 eligible children, 768 (66.4%) were HEU and 388 (33.6%) were PHIV. HEU children were significantly (P < 0.01) more likely to be up to date by 12 and 24 months of age for all vaccines examined. Statistically significant differences persisted when the analyses were limited to children enrolled before 12 months of age. Controlling for birth weight, sex, primary caregiver education and any use of tobacco, alcohol or illegal drugs during pregnancy did not contribute significantly to the logistic regression models.Conclusions: PHIV children were significantly less likely than HEU children to be up to date for their childhood vaccinations at 12 and 24 months of age, even when limited to children enrolled before 12 months of age. Strategies to increase vaccination rates in PHIV are needed.NICHDUniversidade Federal de São Paulo, UNIFESP, Escola Paulista Med, São Paulo, BrazilWestat Corp, Rockville, MD USAUniv São Paulo, Fac Med Ribeirao Preto, BR-14049 Ribeirao Preto, BrazilHosp Infantil Mexico Dr Federico Gomez, Depto Infectol, Clin Inmunodeficiencias, Mexico City, DF, MexicoUniv W Indies, Dept Child & Adolescent Hlth, Kingston, JamaicaNatl Univ San Marcos Lima, Natl Inst Child Hlth, Lima, PeruNatl Univ San Marcos Lima, Fac Med, Lima, PeruHosp Fed Servidores Estado, Rio de Janeiro, BrazilUniv Buenos Aires, Fac Med, Buenos Aires, DF, ArgentinaEunice Kennedy Shriver Natl Inst Child Hlth & Hum, Maternal & Pediat Infect Dis Branch, NIH, Bethesda, MD 20892 USAUniversidade Federal de São Paulo, UNIFESP, Escola Paulista Med, São Paulo, BrazilNICHD: N01-HD-3-3345NICHD: HHSN267200800001CNICHD: N01-HD-8-0001Web of Scienc